Long thread, but first I've glanced at it.
It's a real common issue for those noise exposed in younger years, and everyone else has some degree of tinnitus by their 80s (or earlier) as hearing declines. As pointed out by others, reversible causes should be ruled out, and such are not difficult, just a basic ear exam (? wax blockage) and hearing test by a competent practitioner will verify the nerve loss culprit. Yup, if there's a conductive loss for which surgery would help, that'll be evident, and the rare instances of nerve tumor will show up as a particular type of loss for which an MRI would be indicated for diagnosis. One doesn't need a doc to rule out medications as contributing to tinnitus, just Google "tinnitus and drugs" or whatever, and sneaky stuff like niacin (for cholesterol issues) will show up, not just the aspirin and NSAIDs that most know about (old docs used to advise arthritics to take aspirin "until your ears ring"). OK, fine, if the tinnitus is just a pulsatile one bring that up to your doc cause besides hearing one's pulse through the thin bone, and thinner as we age and lose calcium, separating the carotid artery and hearing portion of the ear is not all that unusual but some blood vessel issues (think aneurysm) can occur, albeit like nerve tumors rarely (your doc will just place a stethoscope against your upper neck and ear, and if they can hear the noise too----then you've got a CT or MR in your future).
OK, so if it's "the usual", nerve loss, stop obsessing about it....cause that's what the preponderance do. Yeah, it's a noise, get over it cause it ain't worth aggravating your blood pressure or sanity. Can't stop the noise, and medications don't work well. One can spend cash on a bunch of stuff, mostly OTC remedies - just peruse PubMed, the Feds gratis listing of all articles in the scientific medical literature, and find proof in a large, case controlled study - ain't there, and if someone had a uniformly effective drug for tinnitus it'd have HUGE profit potential hence no problem getting funding for a verification study. So, what's left? Masking works, by creating a noise louder than the tinnitus ("drown it out" so to speak), and if the masking is perceived as less bothersome than the tinnitus, great. Masking can be by everything from a wave generator at the bedside (your smartphone can download good noise-masking apps for a few bucks) to a hearing aid (makes ambient noise louder). Hey, tranquilizers are modestly effective if that's what it takes (doesn't touch the noise but take enough and one doesn't give a hoot....think alcohol....).
Whatever, tinnitus is usually perceived as loudest when one is in a quiet environment, which is why many are most bothered by it at night. Neat demo for a twenty something who doesn't realize what tinnitus is involves putting them into a sound isolation booth (think hearing test booth) and letting them read a newspaper for 10 minutes or so - they will start hearing tinnitus, soft but present, cause if one lowers background noise to near zero we ALL have some degree of tinnitus, just can't "hear" it in normal circumstances until nerve loss from noise exposure or age begin to nudge the tinnitus into our sphere of consciousness in everyday life.
Parting observation - if tinnitus is from "the usual", i.e., nerve loss from noise exposure or heredity (if your parents needed hearing aids, likely you will too) or disease (some cancer drugs cause a degree of permanent loss), it can't be reversed, just ignored or masked, so do your best to minimize further loss from about the only thing you can control, and that's noise exposure. I wear muffs when on my tractor or riding mower, at the shooting range (ear plugs too), and so on. If your employer offers hearing protection (OSHA rule above certain exposure levels), use them. In most cases (see above) you can't make your hearing better (to all you vets who sustained acoustic trauma while serving our country, we owe you our thanks) and neither can anyone else, but you sure can make it worse - take care out there, folks.
